健康行为改变中的社会认知因素:HAPA模型述评

HAPA是健康行为领域研究的新取向.认为改变健康行为需要两个分离的过程:动机和意志.首先,基于自我信念的基础上形成改变的意图;随意,行为改变才会被计划、引发并维持.HAPA认为,动机阶段引起行为意图,而意志阶段则产生实际行为.以自我效能为代表的社会认知因素在两个阶段起重要作用,对于健康行为的采纳、引发和维持的产生重要的预测作用.     

健康行为改变理论述评

健康行为对个体身心健康的维护和促进、生活质量的提高具有非常重要的意义,健康行为改变理论可以有效地解释和预测个体健康行为的发生和改变.本文介绍并剖析了健康信念模式、保护动机理论、合理行动/计划行为理论和多阶段改变等四种以心理社会因素为基础的健康行为改变理论,并对这些理论的发展趋势做了展望.     

健康行动过程取向模型的发展与前景

健康行动过程取向(HAPA)模型的提出源于健康行为社会认知模型的发展和Bandura社会认知理论的应用。在HAPA中, 健康行为变化被视为一个包括行为产生、保持和恢复在内的连续过程; 结果预期、危险感知、三种自我效能感和两类计划被用来解释意图的形成及其向行动的转化; 两个阶段的划分有助于区分三类干预对象, 建议实施菜单式干预。HAPA模型具有明显的理论优势, 也引发了有关模型实质的争论。当前和未来的研究旨在考察更多的自我调节变量、检验因果模型, 在健康行为的多个领域开展应用和干预研究。     

社交网站使用强度对大学生创新行为的影响：一个有调节的中介模型

为探讨社交网站使用与大学生创新行为的关系,以及创新自我效能感和自尊在二者关系中的作用机制,采用社交网站使用强度量表、Rosenberg自尊量表、创新自我效能量表和创新行为量表,对1014名大学生进行调查。结果表明：(1)社交网站使用强度显著正向预测大学生的创新行为;(2)创新自我效能感在社交网站使用强度和创新行为之间起部分中介作用;(3)社交网站使用强度通过创新自我效能感影响大学生创新行为的前半路径受到自尊的调节,即相对高自尊水平者,低自尊水平者的社交网站使用强度对其创新自我效能感的预测作用更强。     

大学生自我担当对道德困境下亲社会行为意愿的影响：自我效能感和预期自豪的链式中介作用

为探究大学生自我担当对其亲社会行为意愿的影响机制,采用问卷法测查了836名大学生的自我担当水平、一般自我效能感、预期自豪情绪和亲社会行为意愿。结果发现：大学生自我担当不仅能直接促进亲社会行为意愿,还能通过自我效能感经预期自豪的链式中介作用间接影响亲社会行为意愿,但自我效能感的直接预测作用不显著。研究发现为通过责任感激发和道德情绪培养来提升大学生道德水平提供了理论依据。     

教师创造性教学行为与小学生创造性思维的关系：有调节的中介模型

以471名小学生为被试,采用儿童报告法考察教师创造性教学行为与小学生创造性思维的关系,同时探析小学生创意自我效能感的中介作用以及开放性人格的调节作用。结果发现:(1)在控制儿童性别、年龄和父母受教育程度后,感知到的教师创造性教学行为显著正向预测小学生创造性思维的流畅性、变通性和独特性;(2)感知到的教师创造性教学行为可以通过创意自我效能感影响小学生创造性思维的流畅性、变通性和独特性;(3)开放性人格能够调节感知到的教师创造性教学行为对小学生创意自我效能感的作用,个体开放性人格水平越高,小学生感知到的教师创造性教学行为对创意自我效能感的预测作用越强。研究表明,创意自我效能感和人格开放性可能是教师创造性教学行为与学生创造性思维关联的重要机制,改善教师的创造性教学行为,提高创意自我效能感和人格开放性水平,有助于促进小学生的创造性思维发展。     

初中阶段青少年健康行为的因素结构特点分析

本研究以北京地区398名初中学生为被试,以适度睡眠、合理饮食、口腔卫生、体育锻炼、防止久坐五类健康促进行为与冒险、越轨、吸烟、过量饮酒、冒险骑车五类健康危害行为为对象,对其健康行为的因素结构特点进行了分析。研究结果表明,初中阶段青少年的健康危害行为间具有显著的正相关,而健康促进行为间的关系则较为复杂。验证性因素分析结果表明,初中阶段青少年健康行为的因素结构主要包含了两个因素,其中健康生活习惯因素主要包括适度睡眠、合理饮食与口腔卫生三类健康促进行为;冒险生活方式因素则包括了冒险、越轨、吸烟、过量饮酒、冒险骑车五类健康危害行为以及体育锻炼、防止久坐两类健康促进行为。     

健康补偿信念量表中文版的信效度检验

健康补偿信念是指个体认为通过实施健康行为可以补偿或抵消不健康(但愉快)行为的负面影响。修订后的健康补偿信念量表共有18个条目,比原量表增加了一个条目,包含物质使用、饮食或睡眠习惯、压力、体重管理四个因子。总量表及四因子内部一致性信度在0.71～0.87之间,重测信度在0.68～0.79之间。修订后的量表具有良好的信效度,适用于测量中国人的健康补偿信念。     

学习动机、归因、自我效能感与学生自我监控学习行为的关系研究

本研究以266名中小学生为被试,研究了学习动机、归因、自我效能感与自我监控学习行为的关系。结果表明:(1)自我监控学习行为与表面型学习动机有非常显着的负相关,与深层型学习动机有非常显着的正相关,与成就型学习动机无显着相关;(2)自我监控学习行为与成功归因的内控分数成正比,但与失败归因的关系不大;(3)自我监控学习行为与自我效能感有显着正相关关系;(4)学习动机、归因、自我效能感是影响自我监控学习行为的几个重要的内部因素。     

建言效能感结构及其在员工建言行为发生中的作用

作为一种组织促进性行为, 员工建言在知识经济时代对组织的作用日益显著。学界从多角度探讨了建言的发生机制, 然而从认知的视角的研究则较为缺乏。本研究从社会认知理论视角, 构建了建言效能感结构(研究一), 并探索了建言效能感在建言行为发生中的作用(研究二)。研究一从长三角地区企业的26名基层员工中提取建言效能感关键事件, 编制初始问卷, 通过对188个样本的探索性因子分析及对另188个样本的验证性因子分析, 探索并验证了建言效能感的结构及其量表; 研究二通过对401份“员工－上级”配对样本的问卷研究显示, 一般自我效能感对建言行为有着正向影响, 且建言效能感在其中起着中介作用, 工作可得性缓冲调节建言效能感与建言行为之间的关系。     

Social-Cognitive Factors in Changing Health-Related Behaviors

Changing health-related behaviors requires two separate processes that involve motivation and volition, respectively. First, an intention to change is developed, in part on the basis of self-beliefs. Second, the change must be planned, initiated, and maintained, and relapses must be managed; self-regulation plays a critical role in these processes. Social-cognition models of health behavior change address these two processes. One such model, the health action process approach, is explicitly based on the assumption that two distinct phases need to be studied longitudinally, one phase that leads to a behavioral intention and another that leads to the actual behavior. Particular social-cognitive variables may play different roles in the two stages; perceived self-efficacy is the only predictor that seems to be equally important in the two phases.     

Perceived Discrimination and Health-Related Quality of Life: Testing the Reserve Capacity Model in Hispanic Americans

ABSTRACT

This study tested aspects of the Reserve Capacity Model (Gallo & Matthews, 2003 Gallo, L. C. and Matthews, K. A. 2003. Understanding the association between socioeconomic status and physical health: Do negative emotions play a role?. Psychological Bulletin, 129: 10–51. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Gallo, Penedo Espinosa de los Monteros, & Arguelles, 2009 Gallo, L. C., Penedo, F. J., Espinosa de los Monteros, K. and Arguelles, W. 2009. Resiliency in the face of disadvantage: Do Hispanic cultural characteristics protect health outcomes?. Journal of Personality, 77: 1707–1746. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) as a means of understanding disparities in health-related quality of life appraisals among Hispanic Americans. Questionnaire data were collected from 236 Hispanic participants, including measures of perceived discrimination, optimism, social support, symptoms of trait anxiety, and physical and mental health-related quality of life. Path analysis indicated direct, negative associations between perceived discrimination and both forms of health-related quality of life. Results also showed that these relationships were partially mediated by the reserve capacity variable of optimism and by symptoms of anxiety, though evidence for mediation by anxiety was stronger than for optimism. Findings suggest that perceived discrimination depletes intrapersonal reserves in Hispanic Americans, which, in turn, induces negative emotions. Implications for community-level interventions are discussed.     

Emerging Adulthood in American and British Samples: Individuals' Personality and Health Risk Behaviors

The purpose of this study was to examine the relationship between instrumental and expressive traits, and health-related behaviors among individuals in emerging adulthood (18–25 years old) in two Western societies. Individuals (100 males, 100 females) in an American sample and a British sample (36 males, 75 females) completed the Personal Attributes Questionnaire, a measure of neuroticism, the Health Behaviors Inventory, and two measures of perceived physical health. As hypothesized, in support of the androgyny model, individuals in both samples who scored high on both instrumental and expressive traits reported better health practices (i.e. safety belt use, less smoking) than individuals who scored low on both sets of traits or high on only one set of traits, after controlling for neuroticism. As hypothesized, for both samples, neuroticism explained more variance in perceived physical health than the other personality traits.     

Changes in physical activity among coronary and hypertensive patients: A longitudinal study using the Health Action Process Approach

Objectives: Physical activity (PA) is a key factor in cardiovascular disease prevention. Through the Health Action Process Approach (HAPA), the present study investigated the process of change in PA in coronary patients (CPs) and hypertensive patients (HPs).

Design: Longitudinal survey study with two follow-up assessments at 6 and 12 months on 188 CPs and 169 HPs.

Main outcome measures: Intensity and frequency of PA.

Results: A multi-sample analysis indicated the equivalence of almost all the HAPA social cognitive patterns for both patient populations. A latent growth curve model showed strong interrelations among intercepts and slopes of PA, planning and maintenance self-efficacy, but change in planning was not associated with change in PA. Moreover, increase in PA was associated with the value of planning and maintenance self-efficacy reached at the last follow-up

Conclusions: These findings shed light on mechanisms often neglected by the HAPA literature, suggesting reciprocal relationships between PA and its predictors that could define a plausible virtuous circle within the HAPA volitional phase. Moreover, the HAPA social cognitive patterns are essentially identical for patients who had a coronary event (i.e. CPs) and individuals who are at high risk for a coronary event (i.e. HPs).     

A cluster randomised controlled trial of an intervention based on the Health Action Process Approach for increasing fruit and vegetable consumption in Iranian adolescents

Objective: To evaluate an intervention programme based on the Health Action Process Approach and designed to increase the intake of fruit and vegetables (F&V) among Iranian adolescents aged 13 to 18.

Design: A randomised controlled trial with three arms examined the short- (1 month) and long-term (6 months) effects of the intervention. There were two intervention groups (one included adolescents only [A group; n = 510]; the second included mothers and adolescents [M + A group; n = 462]) and a control group (n = 483). All participants were recruited from schools.

Main outcome measures: Social cognitions, self-regulatory processes and F&V intake.

Results: The intervention led to an increase in F&V intake for adolescents in the short and long terms. Adolescents in the M + A group increased their F& V intake more than adolescents in the A group. Outcome expectancies, self-monitoring, intentions, action and coping planning, perceived social support and behavioural automaticity mediated the effect of the intervention on F&V intake.

Conclusion: The theory-based intervention led to an increase in F&V intake and promoted more positive social cognitions and self-regulatory processes among Iranian adolescents. The findings also provide evidence that involving mothers in an intervention can confer additional benefit.     

Cognitive Behavior Therapy for Women With Generalized Anxiety Disorder in the Perinatal Period: Impact on Problematic Behaviors

Generalized anxiety disorder (GAD) is the most frequently diagnosed anxiety disorder among women in the perinatal period (pregnancy to one year postpartum). Recent studies have examined the relationship between problematic behaviors and GAD symptoms. Studies in nonperinatal samples indicate that adults with GAD engage in avoidance and safety behaviors and these behaviors are associated with greater symptom severity. Little research has examined the use of problematic behaviors among pregnant or postpartum women. However, preliminary research suggests that these behaviors may have a negative impact on both anxious women and their children. Our aim was to examine the extent to which women with GAD in pregnancy or the postpartum engage in problematic behaviors and whether cognitive behavioral therapy is effective in reducing these behaviors. Fifty-eight women with GAD in pregnancy or postpartum were recruited from a larger clinical trial (Clinicaltrials.gov ID NCT02850523) evaluating the effectiveness of group-based cognitive behavioral therapy (CBGT) for perinatal anxiety disorders. The results indicated that women with perinatal GAD reported high levels of avoidance and safety behaviors and greater engagement in these behaviors was associated with higher levels of worry and related symptoms. CBGT was effective in reducing GAD symptoms and problematic behaviors and a bidirectional relationship was found between changes in worry and problematic behaviors during treatment. Limitations and future directions are discussed.